| NPI | 1912304080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO 0014404) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MA 9681) |
| 101YP2500X Counselor Professional (Licence: VA 0701011024) | |
| 101YP2500X Counselor Professional (Licence: PA PC014022) | |
| Enumeration Date | 2014-12-04 |
| Last Update Date | 2022-07-08 |